For Couples Without Children, a Strategy for Trimming Health Insurance Costs

By Mike CauseyOctober 18, 1999

Whoever said, "Two can live as cheaply as one" probably wasn't married or the single parent of a teenager with a bottomless pit in lieu of a stomach.

Show me two living as cheaply as one, and I'll show you a real skinny couple who don't have cable.

But federal employee couples can pay less for health insurance than families.

The issue arises because some childless couples feel Uncle Sam favors big families when it comes to health insurance. The government definition of a family is two or more. No discount if there are no children.

(Disclosure: In their youth, my four children did hard time in Sibley and Children's hospitals.)

The theory behind a group plan of 9 million members doesn't impress some two-person families.

Everyone in the group--regardless of age, health or lifestyle--pays the same premiums in the same plans. Most workers and retirees can choose from 14 health plans and can switch annually with no restrictions.

People who have AIDS or cancer or heart problems pay the same premiums in the same plans as the very healthy. Those with a mental illness pay the same premiums as those who don't need or use expensive psychiatric care. Those born with an illness or condition pay the same premiums as those without any problem or disability.

The Sept. 26 Federal Diary attempted to explain why the federal group plan is the way it is. But it didn't console some readers who believe it is unfair to charge two-person families big-family premiums.

A federal employee in Madrid makes the case this way:

"I have reflected on your justification for the practice of charging participants in the federal health plans as single, or as family, regardless of size. I find it very strange that you apparently regard getting married as an activity that should carry a penalty, and that any effort by plans to be more discriminating in the charges would be unfair. On that basis, why is there a distinction at all?

"Why should those pesky single people not have to support the costs of families seeking medical care? It does not seem beyond the capability of human beings to work out a system that would impose a three-tiered charge: single, two persons, and families larger than two and it is hard to understand why you would think that to be unfair.

"Family size is not a question of a medical condition beyond one's ability to control. As it is now, the charge per person is higher for [couples without children] than it is for either single persons or members of three-plus families. That seems to say that public policy is opposed to people who choose to get married, but don't have children."

-- Marshall Carter-Tripp

Congress set up the program, although most members are married, have children and are under the same health plans, and it isn't likely to change the family premium format.

But federal couples can sometimes pay less for coverage--by each enrolling in a single-coverage plan. Next year, Blue Cross singles will pay $30.04 biweekly, compared with $66.78 for family coverage.

Couples can also save by choosing single plans with one rate lower than the other--such as a fee-for-service plan for one and a health maintenance organization for the other.

The catch, sometimes, is the out-of-pocket (catastrophic limit) requirement. If husband and wife have a rough medical year, their deductibles--in two single plans--could be twice as high as the deductible in a family plan.

Postal Privatization

Postmasters general come and go. But they've all agreed on two things: The Postal Service must maintain its first-class-mail delivery monopoly and never, ever, be turned over to private industry. Doing either, they've argued, would destroy service to the public and the service itself.

But today, in a keynote speech prepared for the MailCom '99 convention in Las Vegas, former postmaster general Paul N. Carlin is to advocate privatization and an end to the first-class-mail delivery monopoly. That should rattle cages in the postal community, from the headquarters of big postal unions to the headquarters at L'Enfant Plaza.

With more than 800,000 workers, the Postal Service is the largest single federal agency--and one of the nation's biggest operations.

Carlin is to tell representatives of major mailers that the Postal Service must "cannibalize itself" and privatize parts of its operations to survive. The current service, he says, represents the worst of both worlds: an outfit with the arrogance and mind-set of a corporation with the lack of hustle that characterizes a no-competition federal bureaucracy.

Guess who won't be getting an invitation to any of this years' postal Christmas parties?